The Natural Approach

Introduction from NRAS:

The following article is an account from an RA patient, and is based on their personal experience of living with RA, so will not necessarily reflect the experiences of other RA patients.

NRAS fully support the use of diet and exercise to help manage the symptoms of RA, and acknowledge the importance to patients of having some control over their condition. Exercise and a healthy diet can help greatly by reducing fatigue, maintaining muscle-tone and reducing joint damage caused by greater strain on the joints. Rheumatoid arthritis is a very varied condition, and in the majority of cases the standard treatments of DMARDs (Disease Modifying Anti-Rheumatic Drugs) and biologic therapies are necessary to treat the condition, and are the only treatment proven to slow down the progression of the disease.

As the evidence-base supports the use of DMARDs as the primary treatment of this condition, we would therefore not recommend the use of diet, exercise and other alternative therapies in place of the standard treatments, but hope that this case study and the links to our information on diet and exercise will be of interest to those visiting our website.

Spring 2011: By NRAS member J Kearsey

I first became aware that something wasn’t quite right in 2008 when I trained for the Great North Run with a friend. I had previously enjoyed long distance running and had run the London marathon and numerous half marathons and shorter races. Although it had been several years since I had run a half marathon I had always kept reasonably fit and the previous year had completed a 5 mile leg of a relay race.

During the training I became aware that I was finding the running much harder than I had ever remembered even though we built up our training gradually and we ran a maximum of 2 or 3 times a week. I also found that I was getting a strange burning sensation in my feet at night especially after I had been running. Over a period of months I noticed that I was very stiff in the mornings and found it hard to get my fingers to work when doing household tasks. I was also getting very “fumbly” when trying to get money out of my purse, open jars and do sewing etc. I found that I was getting tired much more easily and couldn’t charge about as I used to. These changes crept up on me gradually and I put it all down to the ageing process and the stresses of running a house, a demanding job and a family with teenagers.

Eventually, in January 2009, having reduced the training significantly after the run in the autumn of 2008 and with the symptoms getting worse not better, I did a google search on my symptoms and was suspicious that I may have RA. My GP was very supportive and immediately ran some blood tests which showed a positive result for rheumatoid factor although negative for the inflammatory markers. This was all rather confusing but he referred me to a rheumatologist who ran various tests and eventually concluded that it appeared that I did have RA.

This was quite a blow and I found it very hard to get my head around the fact that I may need to take the heavy duty drugs which are often needed to control the RA. I left with a prescription for naproxen and literature on methotrexate. I did a lot of reading and research about the various treatments on offer and joined the NRAS which I found very helpful.

During the course of 2009, I attempted to keep up with my running but found it impossible due to the pain in my feet and ankles. Eventually I resorted to going for long walks and took up yoga not knowing at the time that this has been found to be beneficial for RA sufferers.

I continued seeing the rheumatologist, who was understanding about my desire to put off the drug treatments until absolutely necessary, although he gently pointed out that in his experience the long term outcome was better if RA is hit aggressively at an early stage. Meanwhile I was busy exploring various alternative therapies.

Firstly I concentrated on my diet. I consulted a naturopath who advised high doses (4,000 mg a day) of fish oils and a gluten/dairy free diet. I also ate a lot of dark berries and took concentrated cherry juice. I have always had a healthy diet and don’t drink much alcohol, tea or coffee so I didn’t need to make too many other changes. I found the gluten/dairy free regime to be much easier than I thought. I was quite strict in the early months and then relaxed a little, just trying to do as much as possible without getting obsessed with it. My naturopath recommended an excellent cookery book called “Cooking Without” by Barbara Cousins. I found a decent gluten free muesli for breakfast and found that rice milk was very palatable. I virtually cut out alcohol as I found that I felt so ill afterwards that it really wasn’t worth it. White wine seemed to be the worst offender!

Secondly I had regular massages, just for half an hour around the shoulders and neck area. I also had monthly acupuncture sessions which helped with the pain but generally provided a boost to overall wellbeing.

Thirdly I practiced yoga as much as possible. I found it difficult to do on my own but religiously went along to weekly sessions and upped that to twice a week whenever I could fit it in.

By September 2010, although people were commenting on how well I looked I wasn’t convinced that the RA was getting any better. By now it was very painful to wear normal shoes and I lived in Fitflops.  After a particularly stressful period the RA seemed to flare up and my GP put me on a two week course of steroids which was a welcome relief.  I continued with all my strategies although I was beginning to doubt that any of it was having an effect and resigned myself to accepting whatever drugs were offered by the rheumatologist.

Then in December 2010, I became aware that, very gradually, some of my previous symptoms seemed to be improving. I was able to wear proper shoes again for limited periods and I could get my rings on and off my fingers. The early morning stiffness also improved. However I now had pain in my hips so again it was a rather confusing picture.

In January 2011, I returned to the rheumatologist. At the previous appointment four months earlier he had warned me that if my condition was the same or worse it would be time to start treatment and he would favour hydroxychloroquine. I had therefore resigned myself to this course of action. Amazingly this time around he concluded that my condition had improved. He was therefore content that I continue without conventional drugs for the time-being.

I do not know whether the improvement is due to the changes in lifestyle, whether any of these alternative therapies is particularly effective or whether it is the combination of everything. I could just be lucky that for now the condition has improved. I am aware that this condition does fluctuate and that it follows a pattern of remission and flare ups. However, I thought this information would be worth sharing in case it is helpful to other people living with RA.

Useful links:

NRAS information on diet
NRAS information on exercise
ARUK report on complementary therapies (Please note this will open in a new window and will take you directly to this report on the ARUK website).